A Prospective Evaluation of PTFE Graft Patency and Surveillance Techniques in Hemodialysis Access

Cinat, Marianne; Hopkins, James M.; Wilson, Samuel E.

doi:10.1007/s100169900241

Cited by 79 publications

(45 citation statements)

References 19 publications

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“…Indeed, the overall primary and secondary AVG patency (80 and 83% in 12 months, respectively) were comparable with data on AVF constructed with native vessels. In addition, our data are better than what other studies report on primary and secondary patency of prostheses made of PTFE or PUU [2, 3]. …”

Section: Discussioncontrasting

confidence: 70%

“…Moreover, in these patients, the positioning of a ‘long-term’ central venous catheter has a limited duration because of the high rate of thrombotic and infective complications, for which a secondary alternative is to place a biological or a synthetic prosthetic arteriovenous graft (AVG). In this regard, the most used vascular prostheses are those made of polytetrafluoroethylene (PTFE) or polyurethane urea (PUU) [2,3,4], which are usually placed in the forearm and use the deep circle of the accompanying veins as a venous downflow. Although the creation of a prosthetic arteriovenous access using expanded PTFE is technically simple and the short-term results are usually good, with a 90% reported primary patency rate at 6 weeks [2], the long-term patency of these devices is unsatisfactory, the 1-year cumulative secondary patency rate being 36% with none of the grafts patent at 3 years in a recently reported experience [2].…”

Section: Introduction and Aims Of The Studymentioning

confidence: 99%

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Long-Term Favorable Results by Arteriovenous Graft with Omniflow II Prosthesis for Hemodialysis

et al. 2009

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Aims and Methods: In order to decrease arteriovenous graft (AVG) failure and improve long-term patency, we used Omniflow II to perform AVG for hemodialysis access in 38 patients with very compromised vessels who were not suitable for other forms of AVG. Results: At a median follow-up of 38 (range 6–55) months, 31/38 (81%) patients were still alive. At 6, 12 ,18 and 24 months, primary patency was 92, 80, 68 and 60%, whereas secondary patency was 83, 80, 78 and 75%, respectively. The cumulative 38-month prosthetic AVG patency was 70%. No infective event related to the vascular prosthesis occurred. Neither AVG thrombosis nor modifications in thrombophilic pattern were observed; these findings confirm the high hemocompatibility of this prosthetic vascular device. Conclusion: Our experience is extremely encouraging for the use of new biosynthetic devices such as Omniflow II.

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Section: Discussioncontrasting

confidence: 70%

Section: Introduction and Aims Of The Studymentioning

confidence: 99%

Long-Term Favorable Results by Arteriovenous Graft with Omniflow II Prosthesis for Hemodialysis

et al. 2009

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“…5 These rates are comparable to those of ePTFE grafts at 1 year of 77% (primary) and 64% (secondary). 7,8,[13][14][15] The 3-year primary and secondary patency rates in our study of 55% and 72%, respectively, fall within the standards set by the National Kidney Foundation, 16 which recommends that the cumulative patency rates of all dialysis AV grafts should be at least 70% at 1 year, 60% at 2 years, and 50% at 3 years.…”

Section: Discussionmentioning

confidence: 75%

Polyurethane Grafts: A Viable Alternative for Dialysis Arteriovenous Access?

Peng

Tan

2003

Asian Cardiovasc Thorac Ann

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Polyurethane grafts, promoted for their self-sealing properties and low complication rates, were recently introduced for hemodialysis access. We review our experience with this graft material to determine its complication and patency rates. Between January 1995 and December 1999, 118 patients, 75 female and 43 male, with a mean age of 51 years, had a total of 163 polyurethane arteriovenous grafts inserted. The grafts were mostly 6 mm in diameter (69.3%), placed in a loop configuration (91.4%) in the forearm (49.7%). The median follow-up period was 12 months. The grafts were first cannulated for hemodialysis at a median time of 19 days after implantation, with 12% used within 3 days. Thrombosis and infection were the most common complications at rates of 32.7% and 30.0%, respectively. Infection was the most common cause of graft loss (61.5%). These complications were amenable to salvage intervention. The 1-year primary and secondary patency rates were 73% and 86%, respectively; the 3-year secondary patency rate, 72%. The 1-year serviceability rate was 64%. With satisfactory patency rates and the advantage of its self-sealing properties permitting early cannulation, polyurethane grafts provide a viable alternative for hemodialysis access. Early recognition and appropriate management of complications can prolong graft survival.

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“…However, numerous prospective studies evaluating the standard ePTFE grafts report primary or assisted primary patency rates that range from Ͻ10% to as high as 43%. 18,[23][24][25][26] Two recent prospective studies of cuffed ePTFE grafts also reported widely discrepant results. 18,27 The first study from the Mayo Clinic demonstrated a 1-year primary patency rate for cuffed ePTFE (n ϭ 24) and standard ePTFE (n ϭ 24) grafts of 35% and Ͻ10%, respectively.…”

Section: Discussionmentioning

confidence: 99%

A prospective, randomized comparison of bovine carotid artery and expanded polytetrafluoroethylene for permanent hemodialysis vascular access

Kennealey

Elias

Hertl

et al. 2011

Journal of Vascular Surgery

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A Prospective Evaluation of PTFE Graft Patency and Surveillance Techniques in Hemodialysis Access

Cited by 79 publications

References 19 publications

Long-Term Favorable Results by Arteriovenous Graft with Omniflow II Prosthesis for Hemodialysis

Long-Term Favorable Results by Arteriovenous Graft with Omniflow II Prosthesis for Hemodialysis

Polyurethane Grafts: A Viable Alternative for Dialysis Arteriovenous Access?

A prospective, randomized comparison of bovine carotid artery and expanded polytetrafluoroethylene for permanent hemodialysis vascular access

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